ARTHROPLASTY – DEFINITION, TYPES, SHOULDER, THUMB, HIP AND MORE

WHAT IS ARTHROPLASTY?

Arthroplasty, in orthopaedics, is a surgical procedure to restore the function of a damaged joint. The function can be restored by resurfacing the damaged bones and in this and artificial joint, which is knows as prosthesis may also be used.

In arthroplasty, the surgeon removes the damaged part of a joint and replaces it with plastic, metal, or a ceramic device.

The most common type of arthroplasty performed are the knee (also see  Knee Replacement Surgery Cost In India) and hip, but it can also be performed on other joints too such as:

• Elbow
• Ankle
• Wrist
• Thumb
• Shoulder

 

ANATOMY OF JOINTS

A joint is a structure where two or more bones meet to form a stable structure. Majorly all the joints are movable, that is they allow the bones to have a particular movement. All the joints consist of the following structures:

• Cartilage :This type of tissue covers the surface of a bone at a joint. Cartilage also helps im reducing friction of movement within a joint.
• Synovial membrane :The synovial membrane is a tissue that lines the joints and seals it into a joint capsule. The inner side of synovial membrane secretes a clear, sticky fluid, that is known as the synovial fluid, around the joint to lubricate it.
• Synovial fluid :A clear, sticky fluid that is secreted by the synovial membrane to lubricate the joint.
• Ligaments :The joint is surrounded by strong ligaments (tough, elastic bands of connective tissue) to give support to the joint and to limit the joint’s movements. Ligaments connect bone to bone.
• Tendons :Another tough type of connective tissue are tendons that are present on each side of the joint and attach to muscles that control movement of the joint. Tendons connect muscles to bones.
• Bursas :Bursas are fluid filled sacs present between the bones, ligaments or any other nearby structures. They work as a cushion and absorbs are the friction that is produced in a joint.
• Meniscus :It is a curved part of cartilage in the knees and other types of joints

 

DIFFERENCE BETWEEN ARTHROPLASTY V/S JOINT REPLACEMENT

Arthroplasty and joint replacement are one and the same procedure, just the difference is  in their names. Arthroplasty is one of the most successful and advanced procedures performed in the orthopaedics industry.

The term joint replacement often seems to make people a bit scary and develop that fear in them before the surgery that is why the doctors use the term arthroplasty instead of joint replacement more often.

Joint replacement is not as scary as it sounds. In majority of the cases, the surgeon only needs to remove and replace a small portion of the joint and this procedure is known as partial joint replacement. The cases in which the surgeon needs to replace the entire joint is known as total joint replacement or total arthroplasty.

Now a days, most of the arthroplasty procedures are minimally invasive and require only a few small incisions to replace and remove the damaged joint.

The benefits of modern arthroplasty are less tissue damage from surgery and faster recovery times.

 

TYPES OF ARTHROPLASTY

• Interpositional arthroplasty :

This is a very old form of arthroplasty, in which the interposition of some other tissue like skin, muscle or tendon takes places to keep the inflammatory surfaces apart.

• Excisional or resectional arthroplasty  :

In this type, the joint surface and bone is removed. The remaining ends are either attached or are left to give time for scar tissue to fill in the gap.

• Mold arthroplasty :

This is also known as resurfacing arthroplasty or silicon replacement , where either one or both the bone surfaces are trimmed, that is they are molded and then replaces with a smooth metal covering.

 

INDICATIONS OFARTHROPLASTY

There are a number of indications and symptoms that may lead to it

• Joint stiffness
• Frozen shoulder, loose shoulder
• Malalignated joint
• Acetabular dysplasia
• Avascular necrosis
• Rheumatoid arthritis
• Osteoarthritis
• Congenital dislocation of hip joint

 

SHOULDER ARTHROPLASTY

Shoulder arthroplasty or replacements include a deltopectoral approach to save the deltoid and the trans deltoid approach, at the glenoid.

Shoulder replacement surgery is very successful in itself for reducing pain and restoring mobility in people who have end stage shoulder arthritis and sometimes a serious shoulder fracture.

People who cannot undergo shoulder arthroplasty include people who :

• Have active infections
• Have progressive nervous system disease that impacts their joints
• Experience paralysis or loss of deltoid or rotator cuff muscles

 

THUMB ARTHROPLASTY

Thumb arthroplasty or replacement is a surgery to replace either a part or the entire thumb joint at the base of the thumb.

It is performed on patients with advanced thumb arthritis and this procedure is intended to eliminate the pain in the thumb and to restore its function.

In thumb arthroplasty , the surgeon will remove a part or all of the patient’s wrist bone. He may also remove part of the thumb bone. He will reconstruct the joint using cartilage, a tenson that is usually taken from the forearm.

After the surgery one need to start hand therapy to regain the lost motion. The strengthening usually starts about 2 months after the surgery and the patient will be done with therapy and splint in about 3 months after the surgery.

 

HIP ARTHROPLASTY

The hip replacement can either be total or hemi. A total replacement of the hip refers to the replacement of both the acetabulum and femoral head whereas, a hemiarthroplasty refers to replacement of only the femoral head.

This hip replacement surgery is some cases is used for the treatment of injuries like improperly growing or broken hip and for several other medical conditions.

One might need a hip arthroplasty if he or she has hip joint damage that is causing pain and the person is not able to do daily life activities normally.

Following are some of the reasons why one must undergo hip arthroplasty:

• The person has a hip joint damage caused by a fracture or any injury
• Any other surgical treatments failed to provide sufficient relief
• Non-surgical management does not work
• Hip joint damage caused by health conditions such as rheumatoid arthritis or osteoarthritis

 

SURGICAL OPTIONS FOR ARTHROPLASTY

There are several surgical options available for joint replacement or arthroplasty:

• Arthroscopy
• Replacement arthroplasty
• Joint resurfacing
• Osteotomy
• Synovectomy
• Arthrodesis or fusion
• Total joint replacement (arthroplasty)
• Minimally invasive total joint replacement
• Joint revision

Arthroplasty is one of the most successful surgeries in orthopaedics  and it comes with minimal risk of infection and with highest successful rate.